Individual provider Active NPI

Kathleen Ellen Meyer, DNP, GCNS-BC

  • Gerontology Clinical Nurse Specialist
  • Beachwood, OH
National Provider Identifier
1093955072
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
181518 Issued in OH
Practice address
3700 Park East Dr Ste 450
Beachwood, OH 44122-4318
Phone
(866) 849-0692
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X 181518 OH Primary

Addresses

Primary practice location

3700 Park East Dr Ste 450
Beachwood, OH 44122-4318

Mailing address

PO Box 211699
Eagan, MN 55121-3699

Other practice location 1

3696 Beverly Hills Dr
Rocky River, OH 44116-3745
Phone (440) 376-1257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110301001125 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 4486835006 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Home Care Services LLCGroup PAC ID 4385961093, 101 clinicians
St Augustine ManorGroup PAC ID 6709808116, 5 clinicians

Practice addresses (Care Compare)

Whitehouse, OH 43571
Phone (419) 291-4500

7801 Detroit Ave
Cleveland, OH 44102-2813
Phone (216) 634-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
181518OHMDGerontology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Home Care Services, LLC CurrentSince Feb 9, 2026 Accepting new patients
Vpa PC Current Accepting new patients
St Augustine Manor CurrentSince Jan 1, 2025 Accepting new patients
St Augustine Manor CurrentSince Jan 1, 2025 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Feb 9, 2026 Accepting new patients
Signify Health, LLC CurrentSince Jul 1, 2022 Accepting new patients
Vpa PC CurrentSince Jun 1, 2022 Accepting new patients
Vpa PC CurrentSince Jun 1, 2022 Accepting new patients
Vpa PC Current Accepting new patients
St Augustine Manor Past Accepting new patients
Primary Nurse Practitioner Inc PastSince Jul 6, 2007 Accepting new patients
St Augustine Manor Past Accepting new patients

Locations

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

7801 Detroit Ave
Cleveland, OH 44102
Phone (216) 634-7400

1100 Beecher Xing N
Ste D1
Columbus, OH 43230
Phone (614) 796-4446

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

7350 Industrial Park Blvd
Mentor, OH 44060
Phone (216) 732-9480

6707 State Rd
Parma, OH 44134
Phone (440) 888-7722

10220 Waterville St
Whitehouse, OH 43571
Phone (419) 291-4500

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1093955072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 PARK EAST DR STE 450",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224318",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3696 Beverly Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Rocky River",
            "state": "OH",
            "postal_code": "441163745",
            "country_code": "US",
            "telephone_number": "440-376-1257",
            "fax_number": "440-331-7486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "KATHLEEN",
        "middle_name": "ELLEN",
        "credential": "DNP, GCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "OH",
            "license": "181518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.